How is CP taught in your program?

[so somatic]

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Advice needed.

Our CP program is weak, but I think the attendings are open to suggestions on how to teach it. We have once a week lectures, and the department has just agreed to start a CP unknown case conference.

What does your program do to teach you CP if you are in a CP successful program? No offense, but I'd rather not hear if you need to complain at how bad your teaching is...it is bad across the country at many places. Also, I do know that ultimately learning CP is by reading Henry. I'm doing that. Thanks.

 

[DarksideAllstar]

All first year CP residents attend two formal didactic lectures per week spanning topics such as transfusion, hematology, micro, chem, molecular, etc usually each is about 1.5hrs. Second year CP res aren't required to attend, but do in prep for the boards usually (remember our program is split AP and CP).

At our main site we also have weekly coagulation conference (1 hr) and hematology/lymph node/flow/bone marrow (rotating through each topic, one per week) that lasts about 1.5 hours-- this includes scope time, which I think is good for residents who haven't done AP yet. Not sure about our other sites, but I hear that our VA micro rotation is strong in terms of you getting to really learn micro via unknowns, etc (little service work). I'd imagine that there is something going on at the county, but I don't know what it is yet. I'll update you next week.

 

[sohsie]

Advice needed.

Our CP program is weak, but I think the attendings are open to suggestions on how to teach it. We have once a week lectures, and the department has just agreed to start a CP unknown case conference.

What does your program do to teach you CP if you are in a CP successful program? No offense, but I'd rather not hear if you need to complain at how bad your teaching is...it is bad across the country at many places. Also, I do know that ultimately learning CP is by reading Henry. I'm doing that. Thanks.

I think reading Henry is not an effecient use of your time to learn CP. I think you would be better off starting with Mais and supplementing from there.

BB and Heme at my place are strong. BB, the residents write up the daily antiibody workups, transfusion reactions, approve non-standard blood orders, evaluate frequent directed donors at the donor center, field calls for donor evals, work up patients who are refractory to platelets, and Im missing a bunch of other stuff. Heme we have 4 months of servie work plus many conferences throughout the year from multiple sources.

Micro and chem are being overhauled. Right now, for the most part, you have to learn a lot on your own, but the resources are there.

 

[LADoc00]

If people think CP is learned from reading Henry...LMAO.....CP at its core is managerial. It is about managing clinician expectations, offering HR type support the clinical lab staff when needed and providing your rarely needed expertise on reviewing things like peripheral blood smears or crystals.

Are you getting diadactics on how to deal with a sobbing nurse in the neonatal ICU who refuses to redraw for a dying neonate because she labelled the tube wrong??

Are you getting lectures on how to deal with a clinician who storms into your office to demand why his send out test is taking 72 hours??

Are getting guest speakers explain how to ensure compliance with staff who dont want to document WHY a patient needs blood products???

If you want to learn some science behind CP and pass the boards, then go to Osler and ASCP board reviews.

There is no real education for CP because no one in academics really understands how to teach it, mainly because they dont know it themselves!!
LOL......

PS-there some awesome CP faculty that "get it" but they are rare....very rare.

 

[Patholog]

My program had (I am elsewhere now) very strong CP. We had a good case volume, but I think it was mostly because the resident was the front line. I see what LADoc is saying, as a lot of "CP" is mangerial, but there obviously is a lot to learn that is non-managerial. We wrote up all the flows, asked for additional tubes when necessary, did all antibody workups, saw pheresis pts, wrote pheresis orders, counted bone marrows, wrote up blood smears, fluids, etc, dealt with blood culture, contamination issues, spent time at the benches working stuff up, etc, we wrote up nearly all molecular stuff (except for HCV genotypes). We got all the first calls from clinicians, techs, etc. We figured out a solution, or not, but at least we tried, and then took it to staff if we felt it was necessary. Our CP days were very busy. Chemistry is the one rotation that is so nebulous that it suffered. It is precisely what LADoc says it is. Mainly customer service and governemnt regulations and bureacracy and other crap. You cannot teach that, and most residents cannot be involved in it much because we are not certified and cannot make managerial decisions. But you need to memorize CLIA '88 for the boards. We were hit so hard by it on my day, it felt ridiculous, but you only remember the questions with which you had trouble.

 

[CameronFrye]

If people think CP is learned from reading Henry...LMAO.....CP at its core is managerial. It is about managing clinician expectations, offering HR type support the clinical lab staff when needed and providing your rarely needed expertise on reviewing things like peripheral blood smears or crystals.

Are you getting diadactics on how to deal with a sobbing nurse in the neonatal ICU who refuses to redraw for a dying neonate because she labelled the tube wrong??

Are you getting lectures on how to deal with a clinician who storms into your office to demand why his send out test is taking 72 hours??

Are getting guest speakers explain how to ensure compliance with staff who dont want to document WHY a patient needs blood products???

If you want to learn some science behind CP and pass the boards, then go to Osler and ASCP board reviews.

There is no real education for CP because no one in academics really understands how to teach it, mainly because they dont know it themselves!!
LOL......

PS-there some awesome CP faculty that "get it" but they are rare....very rare.

We aren't getting lectures on those things, but we certainly get to deal with a lot of that, since we are the first people to be contacted about a lot of the garbage.

 

[CameronFrye]

I think reading Henry is not an effecient use of your time to learn CP.

I just don't understand some of these criticisms of Henry's. If I have a complaint about Henry's, it's that it's not detailed enough for my rotations. I usually read Henry's at the beginning of a rotation to get an overview on the subject, but then I have to supplement that with subspecialty-specific references the rest of the month.

 

[sohsie]

I just don't understand some of these criticisms of Henry's. If I have a complaint about Henry's, it's that it's not detailed enough for my rotations. I usually read Henry's at the beginning of a rotation to get an overview on the subject, but then I have to supplement that with subspecialty-specific references the rest of the month.

You are kidding, right?

 

[Anna Plastic]

You are kidding, right?

Cameron speaks the truth here. Henry's, as much as it may seem daunting to residents, is a general overview text, and very much needs to be supplemented with outside reading to get to the meat of any particular area.

And LADoc also speaks the truth--most of CP is going to be dealing with customer and laboratory issues that won't be seen in texts. The best way to get an education is with any other education: get involved. If they don't have a good plan for you, and they have you getting some piddling project or worse, the tell the director of the rotation that you want to get all of their calls. Go to every meeting/committee they will let you get away with sitting in on. Deal with every complaint about receiving reports or question about laboratory test interpretation. Get on the phone with every confused nurse who has questions about sample drawing. Go into the O.R. or to the bedside when there is a transfusion issue. Whatever you do, DON'T waste your time M-F 8-5 reading a text. You guys are going to be responsible for running the show in a VERY short period of time--learn by doing now while you still have a safety net.

 

[so somatic]

Thanks Anna Plastic.
That is the sort of advice I was looking for. I have quite a few months of CP coming up and I'll make the extra effort to get involved. Appreciate your thoughts.